Glycodelin-A在非小细胞肺癌中的表达及其与患者临床病理学特征及生存的关系

发布时间：2018-06-29 19:24

  本文选题：非小细胞肺癌 + glycodelin-A　； 参考：《山东大学》2017年硕士论文

【摘要】：目的:非小细胞肺癌是严重危害人类健康的肿瘤,是全球范围内引起癌症死亡的首要原因,患者生存差,迫切需要新的因子来预测患者的生存,以制定个体化的治疗方案。目前有多项研究发现肿瘤细胞可产生glycodelin-A,glycodelin-A的表达与患者的不良预后相关。在非小细胞肺癌患者的研究中,并无明确结论。本研究使用了 125例非小细胞肺癌患者的资料,使用免疫组化法检测glycodelin-A的表达,并分析了 glycodelin-A与患者临床病理学特征之间的关系,以及glycodelin-A表达对于非小细胞肺癌患者生存的影响。方法:免疫组化法检测每个患者的glycodelin-A表达情况并记录,使用卡方检验分析glycodelin-A与患者性别、年龄、吸烟史、病理类型、组织学分级、TNM分期、有无淋巴结转移的关系,使用Kaplan-Meier法及COX单因素、多因素分析法进行生存分析。结果:1、Glycodelin-A在肺癌组织中阳性率为27.2%,在癌旁肺组织中阳性率为11.2%,glycodelin-A在肺癌组织中阳性率较癌旁组织明显增多,P=0.035。2、患者Glycodelin-A表达情况和TNM分期有关系,而与患者的性别、年龄、吸烟史、病理类型、分化程度、是否有淋巴结转移这些因素无关。3、kaplan-meier法和单因素COX模型对于无进展生存期有意义的影响因素结论一致。对于无进展生存期有意义的有:肺癌TNM分期、glycodelin-A蛋白表达情况、是否经过手术治疗、淋巴结转移与否。对于总生存期,kaplan-meier法显示有意义的是:肺癌TNM分期、glycodelin-A蛋白表达情况、是否经过手术治疗、淋巴结转移与否。4、COX多因素分析结果显示:手术是影响患者无进展生存期(p=0.001)的独立因子。吸烟史(p=1.117)、手术治疗(p0.001)是影响患者总生存期的独立因子。5、在男性患者、年龄≥60岁的患者、吸烟患者、鳞癌患者、Ⅲ期患者、低分化患者以及有淋巴结转移的患者,表达glycodelin-A的患者有更短的无进展生存期和总生存期。结论:1、Glycodelin-A的表达情况和患者的TNM分期有关。2、Glycodelin-A阳性表达的患者有更短的无进展生存期和总生存期。3、Glycodelin-A不是无进展生存期和总生存期的独立预后因子。4、TNM分期、是否经过手术治疗、患者淋巴结转移与否也是影响患者无进展生存期和总生存期的因子。5、手术治疗是患者无进展生存期的独立预后因子。吸烟史、手术治疗是患者总生存期的独立预后因子。
[Abstract]:Objective: Non-small cell lung cancer (NSCLC) is a major cause of cancer death in the world and it is a serious threat to human health. Patients with NSCLC have poor survival and need new factors to predict the survival of NSCLC patients so as to formulate individualized treatment schemes. Several studies have found that the expression of glycodelin-A in tumor cells is related to the poor prognosis of patients. There is no clear conclusion in the study of patients with non-small cell lung cancer. The data of 125 patients with non-small cell lung cancer were used to detect the expression of glycodelin-A by immunohistochemical method. The relationship between glycodelin-A and clinicopathological features was analyzed. And the effect of glycodelin-A expression on the survival of patients with non-small cell lung cancer. Methods: immunohistochemical method was used to detect and record the expression of glycodelin-A in each patient. The relationship between glycodelin-A and sex, age, smoking history, pathological type, histological grade and lymph node metastasis was analyzed by chi-square test. Kaplan-Meier method and Cox single factor analysis were used to analyze survival. Results the positive rate of Glycodelin-A and glycodelin-A in lung cancer tissues and adjacent lung tissues was 27.2 and 11.2 respectively. The positive rate of glycodelin-A in lung cancer was significantly higher than that in adjacent tissues. The expression of Glycodelin-A was correlated with TNM staging, but it was related to sex, age and smoking history. Pathological type, degree of differentiation and lymph node metastasis were not related to the correlation between the single factor Cox model and the single factor Cox model. The significance of progression free survival is the expression of glycodelin-A protein in TNM staging of lung cancer, surgical treatment, lymph node metastasis or not. The expression of glycodelin-A protein in TNM staging, surgical treatment, lymph node metastasis, multivariate analysis showed that surgery was an independent factor affecting the progression free survival (p0.001) of patients with lung cancer by using kaplan-meier method. Smoking history (p1. 117), surgical treatment (p0. 001) were independent factors affecting the overall survival of patients. In male patients, patients over 60 years of age, smoking patients, squamous cell carcinoma patients, stage 鈪，

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